HomeMy WebLinkAbout330878 SIMPSON & SIMPSON SALES & SERVICE INC - INSURANCE CERTIFICATE (2)ACII CERTIFICATE OF LIABILITY INSURANCE
DAM(MMIODIYYYYI
9/5/2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsements .
PRODUCER
CONTACT
NAME:
Olson & Olson Ltd
PNHONE pIC No: 7- 2074
5655 S. Yosemite St. #101
E-MAIL
Greenwood Village CO 80111
ADoREss.r_honn a.petsche@olsonandolson,com
INSURER(S) AFFORDING COVERAGE NAIC 0
Og
INSURER A:�4112
INSURED SIMPS-1
INSURER B:PInn �col Assurance
INSURER c: n 1obal Risks U- In o 5300
Simpson & Simpson Sales & Service, Inc.
Russ Doty
INSURER 0
PO BOX 524
Broomfield CO 80038
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: 1297980415 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADOL SUER I POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSR WVO POLICY NUMBER MMIDOIYYYY MWDO/P/YY LIMITS
A
GENERAL LIABILITY
CWP5452191
9/112013
9/112014
EACH OCCURRENCE
12,000 000
X COMMERCIAL GENERAL LIABILITY
OAMA E T N
PREMISES Ea gcwnence
$300,000
CLAIMS -MADE OCCUR
MED EXP(Any am Person)
S10,000
PERSONAL &ADV INJURY
S2,000,000
GENERAL AGGREGATE
$4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
$4,000,000
POLICY I^ PRO- n LOC
IFFT
S
A
AUTOMOBILE
LIABILITY
CWP5452191
9/l/2013
9/1/2014
Eaaacident
$1000,000
X
BODILY INJURY (Per Person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY Per accitlenl
( )
S
NONdOWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
Per acadenl
$
A
X
UMBRELLA LIAR
X
OCCUR
CWP5452191
EACH OCCURRENCE
$2,000000
AGGREGATE
42,000,000
EXCESS LIAB
CLAIMS -MADE
�/1/2013
�11/2014
DED IX IRETENTION$0
$
g
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLl10EDi
NIA
'4095690 -
�/1/2013
�/1/2014
X ITO VLIM U- IOTH-
R Is R
$1,000,000
E.L. EACH ACCIDENT
E. L. DISEASE - EA EMPLOYE
$1.000.000
(Mandatory in NH)
yy
DESCRIPTION OF OPERATIONS EeIuv
E. L. DISEASE -POLICY LIMIT
1 $1.000,000
C
BR/Inst Floater
MZ193022731 '911/2013
9/1/2014
Materials $500,000
Deduct $1.000
OESCRIPTON OF OPERATIONS I LOCATONS I VEHICLES (AltacN ACORD 101, Additiomi Rev s Ud .Ie, If more apace la nqulndl
All Projects.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
300 LaPorte Avenue
Ft. Collins CO 80522
AUTHORIZED REPRESENTATIVE
(E1988-2010 ACORD CORPORATION A)I rinhte reeerver
ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD